A journey to resilience through Interpersonal Group Therapy
United by a shared experience of displacement and the struggles it brings, 12 South Sudanese refugee women sought solace and support in the therapeutic sessions offered through the partnership of StrongMinds and Alliance Forum for Development (AFOD). As they shared their stories, a common theme emerged on the profound impact of food scarcity due to reduced ration on refugee mental health, one of the group members recaps, “The weight of not being able to provide sustenance for our families took a toll in our well-being, manifested in feelings of; sadness, worthlessness, and anxiety but motivated to alleviate the burden of food scarcity, as a group we were integrated by AFOD into the livelihood group where we decided to embark on a journey to cultivate 10 acres of land, for growing maize to ensure improved livelihoods, resilience and self-reliance. Our effort yielded 11 tons of maize and this became a symbol of empowerment and healing for the group members.
The ability to provide for our families has brought a sense of stability in our families, feelings of sadness and anxiety has gradually given way to hope and optimism and a renewed sense of control over our lives. A 30-year-old Grace a group member says the harvest “reminds me of the times I used to have enough to eat with my family before I became a refugee.” Within the confines of a refugee settlement, where hope often seem elusive, this heart warmingstory of transformation is having a huge inspiration to other refugees says, Deborah Bemba, Embedded Program Officer for StrongMinds Uganda, their inspiring narrative sheds light on the interplay between mental health and food security in refugee communities and has ignited a spark of possibility for many refugees. As a group, we hope to grow more food to support our families and to sell the surplus as one way of increasing household income but also use the skills acquired to support more women to overcome depression.
Mary’s Journey from Depression to improved ART adherence through Interpersonal Group Therapy.
Mary Mandera is a 40-year-old South Sudanese refugee living in Pagirinya settlement located in Adjumani district. She recaps, “I was separated from my husband, who was away when the war broke out in South Sudan. Once in Uganda, I felt overwhelmed and isolated, with my children refusing to be supportive with household and farming tasks. As a mother of four children, I struggled to provide for my family much as I sold charcoal and engaged in small-scale farming.
Before attending Interpersonal Group Therapy (IPT-G) sessions, my life was difficult and I often contemplated to commit suicide- which affected my ability to adhere to HIV treatment (ART). One day, a Mental Health volunteer visited and introduced me to a counselling sessions where individuals gather in groups-IPT-G, I decided to participate by attending sessions every Monday for eight weeks, I was assigned personal tasks and upon returning, I shared my progress. During the sessions, I openly discussed my problems and the group advised me to share my pain with my children, I spoke to my children about the impact of their behaviour on my health where they humbly apologized and promised to change. After a short time, my children began to actively support with household chores, farming and becoming more collaborative. After three weeks, I experienced a lot of improvements with my health and the family environment. As a result of attending the IPT-G sessions, I no longer feel the urge to commit suicide and currently my adherence on ART has improved as witnessed by 95% score in the viral load non-suppressed register. The group experience taught me the importance of sharing personal challenges. Reflecting on my journey, I now have the skills to help friends overcome depression and looking forward to continue supporting others struggling with depression for there is hope for rec
“The power of seeking help in the face of adversity”. Joel’s Inspiring Journey
Joel is a 28-year-old resident of Ukusijoni Sub County and a father of two, He shares his remarkable journey of transformation; “I went through discord and hardship, but through the support of a community therapy program, I found a path to a brighter future for myself and family. Before attending therapy sessions, I experienced frequent conflicts with my wife, resulting in strained relations due to my inability to provide for my family, due to depression, I resorted to working at a local park, occasionally borrowing motorcycles “Boda-Boda” to transport passengers. Despite these efforts, I earned meagre commissions, leaving my family financially constrained. This situation prevented us from renting land to engage in productive agriculture. To compound my difficulties, my 9-year-old daughter couldn’t attend school due to lack of money and conflict at home”.
My journey to a peaceful co-existence with my wife began when I learned about depression management by attending community sensitization organized by the AFOD-SMU team in my community., I reached out to a volunteer who conducted an initial assessment, opening the door to a series of transformative sessions where I found the support I desperately needed. The therapy sessions involved; prayer, sharing, exercises, fostering comradeship and sharing valuable life skills and insights on how to navigate future challenges. This group served as a safe space where I sought guidance and support from others facing similar challenges.
As I immersed myself in the therapy program, positive changes began to unfold most notably, the spirit of hard work to provide for the family which inspired and motivated my wife thus our long-standing disagreements paved way for harmony in the family, we learnt that without money, we can’t provide for the family and live peacefully. We began doing casual employment to get some income. As I speak my 9-year-old daughter, previously unable to attend school is now happily attending Primary One, thanks to our joint efforts. This transformation is a testament to the power of seeking help and community support in the face of adversity. Reflecting on this, I wish to extend my heartfelt advice to men facing similar challenges to please join the therapy group and see your families thrive by reaching out to a nearby volunteer and explore your path to healing and growth.
Jenifer’s Path to building resilience and financial Independence”
Janifer is a 23-year-old resident of Pakwinya village, she has a story of family reunification and personal growth following her participation in 8-weeks IPT-G program, “As a mother of one responsible for three other dependent children, I found myself in a situation filled with challenges, in my household, the children I cared for did not respect my authority, often disregarding my instructions and refusing to participate in household and garden tasks. My husband, unfortunately, did not intervene to address the children’s disrespectful behavior. This environment led me to experience sleepless nights and I even experienced suicidal thoughts. I lost interest in everything and my passion for cooking waned as I began contemplating leaving her husband.
However, my journey toward healing began when I heard about a community volunteer administering a therapy session for depression, the volunteer visited me on two occasions, extending an invitation to join a group of women who were also grappling with similar challenges, recognizing the opportunity for support and change, I accepted the invitation. Upon joining the group, I and my fellow members shared our family-related struggles with the group, where valuable advice were given, encouraging us to pray and attempt a calm conversation with our husbands. Unfortunately, my husband initially resisted to change but undeterred, I was advised to turn to my in-laws who successfully mediated a conversation with him and a sense of hope and peace reigned in the family. By the 6th week of the group therapy, I had made significant strides. I began preparing daily meals for my family, engaged in casual work, and even started a local bread-selling business in the market. These newfound endeavours reduced my reliance on my husband and instilled a sense of independence.
Today, my family is characterized by unity and harmony, and I enjoy a positive relationship with my husband. We are now a group of 43 members who have formed a VSLA support group engaged in weekly savings and a source of soft loans for group members. I am filled with gratitude to AFOD and StrongMinds for their impactful work. As a group we request for more financial literacy training and provision of metal boxes and books to support our savings journey. In conclusion. “You can’t get out of depression alone, you have to share your pains with other people to get relieved”.
Alice’s Journey of Resilience
Alice Asienzo’s story shines a beacon of hope. A 47-year-old single mother of five living in the heart of Maaji III, Adjumani refugee settlement in Uganda, Alice’s life has been a tale of triumph over adversity, a journey of resilience that demonstrates the transformative power of community support.
Alice’s life took a drastic turn when she lost her husband in Juba leaving her to shoulder the responsibility of providing for her five children. The weight of solely providing basic needs for her children impacted heavily on her health. The inability to fulfil these basic needs cast a cloud of loneliness over her, leading her to self-isolate and struggle to focus on her daily tasks, this affected her children’s wellbeing and education as life seemed unbearable.
Alice’s life took a new turn when she encountered AFOD-SMU’s community volunteer, who introduced her to a lifeline of hope through Interpersonal Psychotherapy for Groups (IPT-G). The healing journey began with a group of twelve members with each member sharing about their struggles in life. The sessions blends elements of support, spirituality, and communication, creating a safe space for sharing and healing. In her own words, Alice recollects, “The initial grief and loneliness I carried before attending IPT-G was replaced by a newfound strength and a sense of purpose, I applied the lessons learnt which brought positive changes in my family life, the persistent headaches I once suffered vanished, my anger towards children changed. The transformation was so profound and currently our group have initiated a small weekly savings initiative where we pool our resources together to meet our collective needs. As an empowered counsellor, I have extended my newfound strength to others around me”.
Alice’s resilience radiates beyond her immediate circle. Her journey from a state of vulnerability to one of strength earned her the needed respect and support from friends. My advice to single mothers; “Seek support, reach out to community volunteers, and share your struggles”. This story not only highlights the transformative impact of IPT-G but also underscores the power of community connections, illuminates the potential for resilience, recovery and hope even in the face of the most challenging life circumstances.
Rose is a 29-year-old mother of six living in Ayiri village in Adjumani refugee settlement, she shares her remarkable journey of reconciliation through IPT-G (Interpersonal Psychotherapy for Groups). Rose had enjoyed a harmonious relationship with her husband until he fell ill, during this challenging period, Rose remained unwavering, attending to his needs and ensuring his well-being until his referral to Mulago hospital for proper treatment, where they spent a year before finally being discharged.
Upon their return home, Rose faced an unexpected and distressing turn of events, her husband influenced by external pressures and circumstances decided to take on another wife, this decision brought a period of mistreatment and neglect in the family leaving Rose to grapple with lack of basic household necessities. The anger that brewed within her could have easily led to destructive thoughts, not only towards her co-wife but also her husband. It was during this period of distress that Rose’s path crossed with a dedicated community volunteer, after assessing her condition, she was invited to meet with 11 fellow women who were embarking on their journeys of healing and self-improvement through IPT-G. This group served as a lifeline for Rose, offering her newfound hope to rebuild.
Rose candidly recaps, “My primary motive for joining the group was to restore and bridge the rift between my husband. I learnt a lot from the sessions and gained valuable insights and guidance from fellow group members. One pivotal lessons during the therapy sessions that stands out for me was the crucial homework assignment given to me to approach my husband with respect, empathy and kindness which opened the door to dialogue and reconciliation, I bravely undertook this challenge, and to my surprise, my husband responded positively and we engaged in a meaningful conversation, this small step marked the beginning of my healing journey, reconciliation and family reunion. Today, my husband provides for the family and my home is now a haven of peace. Remarkably, my relationship with my co-wife has greatly improved and we live in harmony”. Rose who is currently in category 1 as a result of General food assistance prioritization firmly believes that IPT-G has not only equipped her with the necessary skills to navigate future challenges but has also instilled in her the vital importance of forgiveness. This story is a testament to the power of self-discovery and reconciliation.
The transformative power of community’s support.
No matter how tough life gets, open up. Keje’s story to recovery
Savia Keje is a 56-year-old mother of nine living in Pagirinya in Adjumani refugee settlement. Keje and the family sought refuge in Uganda in 2017. She recounts her experiences as follows; “As a family, we lived fairly well until when I began having marital problems with my husband which led to separation in 2019. To make ends meet, I had to do odd jobs to support the family. Suddenly my husband returned about two years ago but was diagnosed with high blood pressure and diabetes which put additional strain on me, his return caused me more depression and hurt from the pain of abandonment, I constantly felt exhausted, sad most of the time, lost appetite and eventually started losing weight. This was made worst with the daunting tasks of taking care of nine children, a sick husband and worst of all our18-year-old son was diagnosed with cancer in early February 2022”.
“In August 2022, overwhelmed by sadness and pain, I found myself at a stream where I wanted to end my misery by committing suicide. While contemplating suicide, I always thought about who would take care of my children and this worsened my condition even the more. As I continued to suffer in silence, in November 2022, I heard about a group in the community that meet every week to talk about their problems, without a second thought, I immediately joined Agabako group, one of the groups formed as part of the AFOD-SMU partnership to support women battling with depression through group Interpersonal Therapy (IPTG)”.
“Joining the group has been the most important decision I have ever made for I learned that my sadness and suicidal thoughts were all signs of depression which required urgent treatment. With the support of a trained community-based volunteer and members, I was encouraged to share all my pain during the sessions but also had opportunity to listen from others with worst experiences than me. Lately, I have begun to feel a lot better than I have been in the previous months and realized I am not alone in this, I now look forward to the future with optimism. Because of the advice I got, I have started a small business of selling firewood in order to support my family and be self-reliant “I’ve grown stronger and now able to overcome any challenges that may come my way,”. I plan to use my new found knowledge to help fellow community members who are struggling with depression”. Just like Keje, many refugees and host communities, continue to unknowingly suffer from depression without access to treatment and care. AFOD in partnership with Strong Minds uses a therapy model of group interpersonal approach where members are encouraged to share their pains, challenges and discuss solutions to manage these challenges as well as provide support to each another.
My journey to support mental wellness through Group Interpersonal Therapy
A 33-year-old Samuel Ecima has lived in Dzaipi for most of his life and witnessed firsthand the damage caused by mental illnesses among host and refugees communities. When he heard that AFOD and Strong Minds were in search of volunteers to provide group Interpersonal Therapy (IPT), he saw it as an opportunity to offer himself to support his people.
Ecima is part of the 40 volunteers recruited and trained by the AFOD/Strong minds to administer IPT-G for the treatment of depression which has ravaged both the refugee and host communities of Adjumani district. He shares; “I was trained on how to carry out IPT therapy, a first line treatment for depression, my tasks involve identifying clients in the community, pre-assess and enroll them for pre-group sessions which last six weeks, I am in charge of three therapy groups of Amaalu, Amechiti, and Anyimitawa made up of between 8-10 clients from the nearby villages of Dzaipi Central and Silili. “I have come to realize that many people are depressed but they don’t know how and where to get help, so instead they take to drinking alcohol while others isolate themselves and go through suicidal thoughts as a solution to their depression, but with this project, we have been able to identify and enroll them for therapy sessions which has led to tremendous improvement in their lives” says Ecima.
One of the beneficiary of the therapy, a 44-year-old Christopher Akomu attests to the benefits of the services being offered; “Ecima is a good counselor and has been of great help to me personally by supporting me to overcome depression and suicidal feelings having lost my wife. Even though we’re coming close to the end of our therapy, I’ll continue contacting him for advice since we’re now personal friends” he says.
Such has been the importance of the Dzaipi based volunteer’s therapy groups that treat depression. The project is attracting high demands for enrollment but one can’t join sessions mid-way since we’re close to termination of the current clients, we only hope that the programme continues next year.”
The start has not been all rosy for Ecima in Dzaipi, “I had to endure ridicule from community members who didn’t take me and the other volunteers seriously due to misconceptions about mental health problems but my determination has not only earned me the good will and admiration from the community members, but also gradually made me respected in the community where I am now called “Lapwony” (teacher), a reference which fills me with pride”.
Ojara is a 35 years old widow with 10 children, she lost her husband in 2007, she narrates, “The loss of my husband triggered intense feelings of grief. I sunk into pain by not accepting that my husband was long gone, I experienced a long-lasting bitterness over his loss, my life lost meaning with my situation getting worst when in 2017, my son got a job and moved back to South Sudan and decided to cut all communications with the family hence I felt abandoned and started getting headaches that never seemed to go away. I became more forgetful and unable to concentrate on any tasks; my family members were so much affected, I frequently had disagreements with my grown up children. Due to my inability to process and cope with stress, I found myself withdraw from society”.
Around that time, Scovia Amadrio, a community volunteer came to Ojara on the recommendation of a friend, assessed her and discovered she was suffering from depression. Scovia recommended treatment, which she agreed to and she was enrolled for group Interpersonal therapy (IPT-G). When she first came for group therapy, she didn’t want to be around other people and preferred to be alone but with time she gradually began to open up as she became more used to the other group members who shared even more painful experiences that strengthened her,” recounts Amadrio Scovia. Ojara now admits, “I will continue to attend therapy along with other members of the Amanzora group because this has made me to be a better version of myself with the counselling provided during IPT-G. I’ve learned to cope with my loss by letting go of my pain and trying to move on because of the positive coping mechanisms skills I have acquired through interpersonal group therapy”
The constant headaches are long gone; you too can overcome depressionBaatio’s path to recovery.
In Adjumani district, 82% of households reported having a family member suffering from a mental health disorder according to AFOD-EACAS 2021 Baseline survey. Depression among other illnesses remains a silent killer. Baatio Sarafina is a 48-year-old mother of six children living in Ayiri Village. In an interface with her, she opened up about her family, “My husband and elder son abandoned their responsibilities as household heads hence leaving me to fend for the two families. This put a strain on my health as I was frequently admitted to the hospital. My son turned into a habitual thief in the village and gave my family a bad reputation, this anxiety made me to develop constant headaches, sadness, physical weakness and eventually high blood pressure. I began to consider abandoning the family as well as I felt the burden was too much to bear alone. I continued to weep in silence.”
Scovia Amadrio, a community volunteer, visited Baatio’s home during a mental health sensitization session in Ayiri village and shared information about depression and its signs. “At first, Baatio paid little interest in the information but when I shared in-depth, she took interest and recognized that she’d experienced some of the symptoms that I mentioned. I assessed her and recommended therapy, which she accepted, and later enrolled her in the group Interpersonal Therapy (IPT-G),” During a follow visit, Baatio opened up on the followings; “I was afraid to share my struggles with others for fear of being mocked and stigmatized. Later, I came to appreciate the group’s sessions for it gave me more courage to freely share my burdens with others. I also benefited from the advice of group members who had similar problems and experiences. I’m less afraid now and feel I have a group of sisters who are always ready to support me through any difficulties. I have adapted positive coping mechanisms, gained strength to raise my children and joined a local savings group to manage my small finances. The constant headaches are long gone with reduced blood pressure, she exclaims!”
A selfless Journey to support women overcome depression
26-year-old Victoria Asienzo has witnessed many families torn apart as a result of depression and avoidable conflicts. She has always been on the lookout for how to change the situation and in October 2022, an opportunity knocked on her door, Victoria learnt about a volunteer opportunity with AFOD/Strong Minds project to provide group Interpersonal Therapy (IPT) and she became one of the 40 volunteers recruited and trained to administer IPT-G for the treatment of depression.
She shares her story; “Many women in my community are depressed due to conflicts that can be avoided with many suffering in silence, unaware of when and where to seek help thus they resort to unhealthy coping mechanisms such as isolation, violence, and drug abuse. As a trained volunteer, I offer support to the vulnerable in my community, I am in charge of 3 therapy groups of; Alendro, Alera, and Anjo ‘meaning Happiness’ in the villages of Dzaipi Central and Silili.” I do screening and enrollment of women for therapy sessions.
This has been a learning experience for myself and the clients, “I’ve noticed a great change in the families I work with since the start of the therapy. Women are now more encouraged to open up, share their challenges and face them head-on through positive coping skills. My reward is the positive feedback and testimonies I receive during each session where women report feeling much better and knowing how to handle their relationships with their spouses, friends, and family in a much better way, such feedbacks fills me with pride and encourage me to continue administering IPT-G. In my family and neighborhood, I am now referred to as a problem solver. My contribution in the community is highly valued and appreciated.